Status of reform effort: Governor Rendell’s proposed health care reform plan, Prescription for Pennsylvania, was introduced into the state legislature, but not acted on. However, several bills aimed at achieving smaller elements of the health care reform plan were enacted. Legislation to expand coverage to uninsured adults was passed by the Pennsylvania House in March 2008.

In January 2007, Governor Edward Rendell (D) proposed “Prescription for Pennsylvania” to expand affordable health care coverage, increase quality, and control health care costs.  The coverage component of Prescription for Pennsylvania, Cover All Pennsylvanians (CAP), would build on the state’s “Cover All Kids” initiative by offering affordable health insurance coverage to uninsured adults and small businesses through the private insurance market.  The plan would:

• Provide premium subsidies to individuals with incomes less than 300 percent of the federal poverty level;
• Mandate insurance coverage for adults with incomes above 300 percent of the federal poverty level;
• Require full-time college and graduate students to obtain a minimum level of health insurance;
• Reform the private insurance market;
• Give parents the option to extend their health insurance to cover their dependents, up to age 30. 

The Governor proposed to finance the plan through a fair share tax equal on employers that do not provide health care coverage to their workers, along with general revenues, federal government funding, tobacco settlement funds, and funds that Pennsylvania Blue Cross plans would be required to reinvest in the community. 

The Governor’s proposal was introduced as House Bill 700, the “Pennsylvania Health Care Reform Act.” While the Governor’s proposal was not enacted in its entirety, activity in the state has focused on considering individual bills and using executive authority to achieve some of the elements in the Pennsylvania Health Care Reform Act.  The Governor signed legislation that:

• Established the Office of Health Equity in the Department of Public Health
• Created the Chronic Care Management Commission, which is responsible for improving the management of chronic diseases. 
• Improved patient safety by eliminating hospital and health-facility-acquired infections and to address the provider shortage problem in the state by enabling nurses and other practitioners to practice to the fullest extent of their training and skills. 

The Governor also announced a program that will identify and stop Medicaid payments for care due to preventable hospital errors, and will prohibit hospitals from charging patients for these errors. 

Legislation expanding health coverage to some uninsured adults was passed by the Pennsylvania House and has been sent to the state Senate. S.B. 1137 is intended to serve as an alternative to Governor Rendell’s “Cover All Pennsylvanians” proposal and is supported by the Governor.*

* H.B. 700.  2007 Legislative Session.  For bill text see: http://www.gohcr.state.pa.us/prescription-for-pennsylvania/HOUSEBILL700P_N_1011.htm.  2007 Legislative Session. For bill text see: http://www.legis.state.pa.us/CFDOCS/Legis/PN/Public/btCheck.cfm?txtType=HTM&sessYr=2007&sessInd=0&billBody=S&billTyp=B&billNbr=1137&pn=1838.